直接口服抗凝药在慢性肾脏病合并心房颤动患者中的应用

Application of direct-acting oral anticoagulants in chronic kidney disease patients complicated with atrial fibrillation

慢性肾脏病(CKD)与心房颤动密切相关,CKD患者的房颤患病率明显高于普通人群,而且这些患者发生心脑血管疾病和全因死亡的风险也明显增高。目前研究表明,对合并轻-中度肾功能异常的房颤患者进行抗凝治疗是有益的,而对于合并重度肾功能不全或接受维持性透析的房颤患者是否进行抗凝治疗尚存争议。本文对直接口服抗凝药(DOACs)的特点、选择、剂量、疗效及安全性方面的研究进展进行综述,旨在为利用DOACs治疗CKD合并房颤患者的临床工作提供参考。

Chronic kidney disease(CKD)is closely related to atrial fibrillation.The prevalence of atrial fibrillation in CKD patients is significantly higher than that in the general population,and the risk of cardio-cerebrovascular disease and all-cause death in these patients is also significantly higher.At present,studies have shown that anticoagulation therapy is beneficial for patients with atrial fibrillation complicated with mild to moderate renal dysfunction,while there is still controversy about whether anticoagulation therapy should be performed for patients with atrial fibrillation complicated with severe renal insufficiency or undergoing maintenance dialysis.This article reviewed the research progress in the characteristics,choice,dosage,efficacy and safety of direct-acting oral anticoagulants(DOACs),in order to provide a reference for the clinical work of using DOACs to treat CKD patients with atrial ibrillation.